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U.S. surgeon general and University leaders discuss public health, opioid addiction prevention

Thursday, March 22, 2018 - 5:28pm

Jerome M. Adams, M.D., M.P.H. Surgeon General of the United States speaks on the topic of "Better Health Through Better Partnerships" at the IHPI Director's Lecture in Robertson Auditorium Thursday. Buy this photo

U.S. Surgeon General Jerome Adams came to the University of Michigan campus Thursday to meet with University and community leaders and deliver the Institute for Healthcare Policy and Innovation’s Director’s Lecture.

About 400 people attended the talk at the Roberston Auditorium in the Ross School of Business, titled “Better Health Through Better Partnerships” — a nod to what Adams has called his top priority as surgeon general.

Before the talk, Adams met with University students for a roundtable discussion. Medical student Raymond Strobel told The Daily in an email interview he enjoyed the opportunity to talk with Adams. The surgeon general’s thoughts resonated with him.

“The roundtable was a terrific opportunity to meet and hear from the Surgeon General,” Strobel wrote. “His points on health policy advocacy were great: in today’s society, we need to work hard to “widen our tent” – choosing to be inclusive and diplomatic when seeking common ground on health priorities with others – and remember our role as servant leaders in healthcare. His thoughts on students’ roles in advocacy were also timely; he urged not to think of ourselves (students) as the future, but the now.”

Following a morning of meetings and discussions with campus leaders, Adams began his lecture in conversation with IHPI director John Ayanian. Adams highlighted the need to create partnerships in health care, something he learned while serving as state health commissioner of Indiana under then-Governor Mike Pence. He said he could have picked a disease or condition to focus on, but instead, is hoping to look at the bigger picture of health care.

“I could have picked a disease … And we could have moved the needle on that issue in a meaningful way,” he said. “But we really want to move upstream, and that’s why my motto is better health through better partnerships, and why I’m focused on forging those partnerships.”

The economic side of health care is also a primary focus of Adams’s; he sees health care issues as deeply connected to economic issues, which most voters focus on.

“It’s more a discussion about jobs and the economy,” Adams said. “People can’t pay their bills if they’re going bankrupt trying to pay their medical bills … And we know that communities that are healthier are more prosperous.”

Adams, who previously served as chair of the Professional Diversity Committee for the American Society of Anesthesiologists, also discussed the need to promote diversity in health care professions. To Adams, diversity and equality need to be framed in a way that shows how both are beneficial.

“When you have those conversations, you automatically group yourself into one of two groups,” Adams said. “Are you oppressed, or are you the oppressor? We need to be able to have a conversation with individuals that shows them how they all fit under the tent. I believe there’s a case to be made in almost every situation that diversity helps everybody, that lowering disparities helps everybody. But we need to be better about making that case.”

Three panelists also joined Adams and Ayanian to further discuss partnerships in public health and how they can help address the nation’s growing opioid epidemic. Panelist Chad Brummett, director of clinical research in the University’s Department of Anesthesiology, mentioned his unit’s preventative approach to the issue.

“We’re really focused initially on keeping people healthy and instead of talking about what to do with the chronic opioid user before surgery, which is an inherently challenging problem, want to take people that are not using opioids and make sure they’re not going down that path,” Brummett said.

Adams emphasized his support for this plan, saying it needs to be accompanied with open dialogues and changes in perspective.

“There’s a role on the provider side of meeting a demand for a pill to fix everything, meeting a demand for opioids as opposed to alternatives,” he said. “And we need to have a change in perspective. We need you all to have discussions in your communities, at your boardroom tables, at your break room tables, at your dinner tables, about how dangerous these medications can be.”

The conversation made its way back to the central idea of partnerships when Rebecca Cunningham, professor and director of the University Injury Center, discussed how the center partnered with law enforcement officials to come up with collaborative solutions to drug trafficking. She’s hopeful this partnership could help in future crises.

“I think the lessons we learn now about opioids will help us down the road,” Cunningham said. “There’s lessons that were learned during the cocaine epidemic and the HIV epidemic and I think that the things we’re learning now with the opioid epidemic that may help us with the firearm epidemic.”

The panelists then segued into their views on gun control, in light of last month’s Parkland, Fla., shooting at Marjory Stoneman Douglas High School. All agreed that, as the second-highest cause of death for children in the U.S. and the leading cause of death for Black children, gun violence is a major public health issue.

According to Cunningham, collecting information is a crucial step to coming up with solutions — second only to finding common ground in the increasingly polarized gun control debate.

“We have to find some common ground around it,” Cunningham said. “I think the kids in Parkland have helped some with the debate around that … If we can start with that ground-level piece, and then the science and injury-prevention person in me says what do we know? And we realize pretty quickly that we don’t have a lot of data about what we know and what we don’t know.”

Adams chimed in, explaining he doesn’t like to use the phrase “gun control,” opting instead for “gun safety."

“Our country was founded by people who did not want to be controlled,” he said.

Before the talk, audience member Lukonde Mulenga, a Public Health graduate student, pointed out the fine line Adams has to walk as a public health servant and government official.

“I know he has a special relationship where he is — he’s the public health officer for the entire nation, but he also has to work with the government,” she said.

Following this discussion, the panel took questions from attendees. In response to a question about universal access to health care and addiction treatment, panelist Joneigh Khaldun, director and health officer of Detroit Health Services, said doctors and communities need to focus on meeting people where they are.

“I think, wherever the system, and I say system very broadly, is reaching hands and reaching people … How can we support people wherever they are so they can get access to the treatment that they need?” she said.

The lecture ended with a performance of two original songs from School of Music, Theatre & Dance students, which were written after talking to families that had been directly affected by the opioid crisis. After the performance, Adams closed the event with a message of optimism.

“I’m convinced there is hope,” Adams said. “In Massachusetts, they turned around their overdose rates, and in Rhode Island, they turned around their overdose rates … How’d they do it? They did it through collaboration and partnerships.”